The Effect of Rosmarinic Acid on Wound Healing of Nasal Mucosa in the Rats.

BACKGROUND: The nose can be damaged by environmental pollutants and foreign bodies, as well as a result of trauma, infection or surgical interventions. Proper healing of the damaged nasal mucosa is important for health. OBJECTIVE: There is no study in the literature investigating the effects of rosmarinic acid on mucosal healing. The aim of this study was to investigate the effect of rosmarinic acid on nasal mucosal healing. METHODS: 21 male, adult Spraque Dawley albino rats were divided into three groups as the control group, the local treatment group in which rosmarinic acid was applied locally to the nasal mucosa, and the systemic treatment group in which rosmarinic acid was injected intraperitoneally. The wound area was obtained by creating a trauma area by inserting a 10 mm interdental brush through the right nasal nostril into the right nasal cavities of all animals. For the following 15 days, the treatment agent was applied as indicated once a day and on the 15th day the animals were decapitated and tissue samples taken from the nasal mucosa were prepared for histopathological examination. The preparations were examined in terms of cellular hyperplasia, goblet cell hypertrophy and degeneration, leukocyte infiltration, cilia loss and degeneration, edema and vascular dilatation, and they have been classified into four categories as mild (+), moderate (++), severe (+++) and very severe (++++). RESULTS: There was a significant difference between the groups in terms of all parameters evaluated, and there is a decrease in the intensity of the parameters with transition from the control group to the local group and from there to the systemic group. CONCLUSION: Systemic rosmarinic acid administration showed an enhancing effect on the healing of experimentally induced nasal mucosal injury due to its possible anti-inflammatory effect.

Heavy metal worker's pneumonoconiosis with lung parenchymal damage and Peripheral neuropathy: case report.

Heavy metals even at low concentrations can damage all systems in the human body from the cellular level by causing disruptions in DNA repair mechanisms, cell division and apoptosis. A 49-year-old man who had been working in the sanding and deburring department of a factory producing underground water pipes for 15 years, presented with complaints of effort dyspnea, cough and loss of strength in his left hand. Computed tomography of the lung revealed diffuse micronodular appearance in all zones in both lungs, subpleural nodule and bronchial dilatation. All serological tests for autoimmune disease were negative. Neurological examination of the patient revealed signs of 2nd motor neuron involvement only in one upper extremity. All of the tests that were studied for the differential diagnosis of multifocal motor neuropathy were found negative. Open lung biopsy with videothoracoscopy was practiced and interstitial changes were observed in the lung parenchyma with intense iron accumulation with Prussian blue stain. The patient was diagnosed with hard metal lung disease (HMLD) and toxic neuropathy (TN) with peripheral nerve involvement due to exposure to metal dust in the working environment. Although the patient had no loss of lung function, he was removed from the working environment, because of function loss in the left hand and is still being followed up.

Protective and Therapeutic Effect of Platelet-Rich Plasma on Experimental Cisplatin Ototoxicity.

Objective: Cisplatin is a chemotherapeutic agent with an ototoxic effect that is frequently used in head and neck cancers. There are studies in the literature conducted with various antioxidant substances to protect and/or prevent ototoxicity. This study aims to investigate whether platelet-rich plasma (PRP) has a protective and therapeutic effect on cisplatin ototoxicity. Methods: A total of 40 Sprague Dawley albino rats were divided into six groups as control group (n=6), PRP-only group (n=6), cisplatin group (n=6), cisplatin + PRP group (n=6), PRP + cisplatin group (n=6), and donor group (n=10). At the beginning of the study and the 8th day, they were tested with distortion product otoacoustic emission (DPOAE). Assessment of DPOAE results was based on the signal-to-noise ratio in 2000, 3000, 4000, 6000, and 8000 Hz frequency bands. On the 8th day, the rats were sacrificed. For histological examinations, the temporal bones were dissected and fixed. After hematoxylin and eosin staining, the tissues were evaluated by light microscopy. Results: In the DPOAE tests performed on the 0th and 8th days of the cisplatin group, it was observed that cisplatin caused hearing loss in the rat ears. It was determined that the cisplatin group at 2000 Hz, 3000 Hz and 4000 Hz had a significant decrease in hearing compared to all groups (p<0.015), while the cisplatin group at 6000 and 8000 Hz was characterized by hearing loss at a higher rate than all groups (p<0.001). At the end of the study, negative effects of cisplatin on both cellular dimensions (cytoplasmic vacuolization, cell degeneration, dilatation, apoptotic cells, nerve degeneration) and hearing function were observed. No protective or therapeutic effect of PRP on cisplatin ototoxicity was observed. Conclusion: Our study showed that platelet-rich plasma did not have a significant effect in the treatment of hearing loss due to cisplatin ototoxicity and in preventing hearing loss in rats.

Mucin receptors in chronic rhinosinusitis with nasal polyps.

BACKGROUND: Nasal polyps (NPs) are non-neoplastic, painless inflammatory lesions of the sino-nasal mucosa. Nasal polyp physiopathology is not yet fully understood. There are many potential etiologies of NP, including chronic infections, allergies, asthma, aspirin sensitivity, anatomical disorders, and genetic causes. OBJECTIVE: The purpose of our study was to immunohistochemically demonstrate the presence of mucin (MUC) receptors in chronic rhinosinusitis (CRS) with nasal polyps and determine the relationships between the presence of these receptors and clinical findings. MATERIAL AND METHODS: A total of 59 patients who underwent functional endoscopic sinus surgery due to CRS with NPs were included in the study. Groups with positive and negative MUC receptors were evaluated according to their clinical characteristics. RESULTS: According to the data we have obtained, surgery site quality and low-dose steroid response worsened with MUC5A receptor positivity and there were no significant relationships between MUC1 receptor positivity and clinical findings. CONCLUSION: According to our results, MUC5A receptor positivity was associated with impaired surgical site quality and a reduced response to low-dose systemic steroids by NPs.

Injury Mechanism of Button Batteries in the Nasal Cavity and Possible Mitigation Strategies During Impaction.

OBJECTIVE/HYPOTHESIS: Button batteries (BBs) impacted in the nasal cavity can cause several complications. Understanding the injury mechanism and developing possible mitigation strategies can reduce these complications. STUDY DESIGN: Cadaveric sheep nasal septum model. METHODS: Lithium, alkaline, silver oxide, and zinc-air BBs were placed on segments of the nasal septum of cadaveric sheep. The BB voltage, tissue temperatures, and pH were measured every 30 minutes for 6 hours. Subsequently, 5 drops of lemon juice, apple cider vinegar, tea, Coke (Coca-Cola Co., Atlanta, GA), tap water, and normal saline were applied separately to the other segments with the lithium BBs every 10 minutes for 3 hours. The visible injuries and the necrosis depths were assessed through the tissue temperatures, pH, and the voltage changes. RESULTS: Both nonlithium and lithium BBs increased tissue pH without significant temperature changes. The 3V lithium BBs led to the greatest depth of necrosis, with a voltage loss of approximately 50% within the first 2 hours. Lemon juice and apple cider vinegar were the most effective liquids for reducing visible injury, pH, and necrosis without increasing the temperature during pre-removal time period. CONCLUSION: Nonlithium and lithium BBs caused alkaline tissue injury in a nasal septal model. Given the hazard severity, expedited BB removal is critical. For situations when removal cannot be immediately performed, further in vivo study is needed prior to considering human use of any pre-removal mitigation strategies in the nasal cavity. LEVEL OF EVIDENCE: NA Laryngoscope, 130:2487-2493, 2020.

A potential post-removal pH neutralization strategy to mitigate nasal button battery injuries.

OBJECTIVE: Button batteries (BBs) impacted in the nose of children can cause septal perforation, synechia, atrophy, necrosis and deformities such as saddle nose. Developing mitigation strategies that can reduce tissue damage after BB removal can decrease these complications. METHODS: 3 V lithium BBs were placed on the cadaveric sheep nasal septum model segments. After 3, 6, 12 and 24 h, BB on each segment was removed and intermittent irrigation was performed with 0.25% acetic acid solution. Irrigation with saline was performed as the control. Visual tissue damage that occurred just before and after irrigation was photographed. BB voltage, temperature and pH changes in the tissue were recorded. Each segment was examined after irrigation for the depth of necrosis and presence of cartilage necrosis. RESULTS: The voltage of 3 V lithium BB was observed to drop to about half at the end of the 3rd hour. It was observed that full-thickness mucoperichondrial necrosis occurred in the nasal septum segments at all time points. Although 0.25% acetic acid irrigation significantly decreased tissue pH compared to saline without increasing temperature, it did not show a significant superiority compared to saline in reducing neither visually nor histologically damage. While cartilage necrosis was not observed for the first 12 h, it was measured 105 µm in the segment irrigated with 0.25% acetic acid at the end of 24 h, and 518 µm in the segment irrigated with saline. CONCLUSIONS: The pH neutralization strategy with post-removal 0.25% acetic acid irrigation to mitigate nasal BB injury appears to be ineffective in reducing the full-thickness mucoperichondrial necrosis starting within 3 h. Although this strategy seems to decrease the progression of cartilage necrosis starting after 12 h, the development of pre-removal strategies for the first 3 h may be more effective and superior in reducing mucoperichondrial damage.

The effect of rosmarinic acid on the prevention of myringosclerosis.

OBJECTIVES: Myringosclerosis commonly occurs as a long-term complication of ventilation during the treatment of otitis media. We aimed to determine the effects of rosmarinic acid as an antioxidant on experimentally induced myringosclerosis. METHODS: Twenty-four male Sprague-Dawley rats, weighing 250-300 g, were unilaterally myringotomized and randomly separated into three groups. Group 1 received no treatment (control group) (n = 8); Group 2 received topical rosmarinic acid (n = 8); Group 3 received oral rosmarinic acid (n = 8). On the twenty-first day, the right ears were examined by otomicroscope and findings of myringosclerosis were recorded. Finally, all of the rats were euthanized and the tympanic membrane (TM) thickness and the severity of middle ear mucosal inflammation were evaluated histopathologically. RESULTS: The myringosclerosis severity, TM thickness, and inflammation scores were found to be significantly higher in the control group than in the topical and systemic treatment groups (p < 0.05). There were no statistically significant differences in terms of TM thickness and inflammation scores between the topical and systemic treatment groups (p > 0.05). While moderate and severe myringosclerosis were higher in the control group, mild myringosclerosis was found to be higher in both treatment groups. CONCLUSION: The local and oral administration of rosmarinic acid suppressed inflammation, reduced TM thickness, and prevented the development of myringosclerosis in myringotomized rats.

Comparison of two modern and conventional tonsillectomy techniques in terms of postoperative pain and collateral tissue damage.

PURPOSE: To compare the tonsillectomy operations performed with bipolar radiofrequency clamp (BRC), plasma blade (PB), and cold dissection (CD) techniques in terms of postoperative pain and collateral tissue damage. METHODS: This is a prospective randomized comparative cohort study conducted in a tertiary hospital. A total of 50 patients who underwent tonsillectomy in our institution met the inclusion criteria. Based on the tonsillectomy technique, patients were randomly divided into 3 groups as BRC (CURIS®) (n:20), PB (PEAK Surgical) (n:20), and CD (n:10). The patients were given a visual analog scale (VAS) for pain evaluation on the 1st postoperative day (3rd h) and on the 3rd and 6th days after discharge. The deepest and the most superficial necrosis depths were examined under the light microscope (Olympus BX53, Japan) by the same single blinded pathologist. RESULTS: The age of the patients included in the study ranged from 5 to 45 years. The mean age was 14.5 years. Twenty-four of the patients were female, 26 were male. Mean 3rd h and 3rd day VAS scores for pain in the BRC group were significantly higher than the other two groups (p < 0.001). Although PB group had higher VAS scores compared with CD group, the difference was not significant (p > 0.05). The deepest necrosis depths (dND) in patients who were operated with BRC was significantly greater compared to patients operated with PB (p < 0.01), whereas no significant difference was observed between the techniques regarding the most superficial necrosis depth (msND) (p > 0.05). For patients operated with CD technique, only ischemic fields were observed. CONCLUSION: Both BRC and PB techniques seem to not provide significant advantage compared with conventional CD technique in terms of postoperative pain. Necrosis depths in tonsillectomy specimens due to thermal damage positively correlate with the postoperative pain level.

The effect of atorvastatin on penile intracavernosal pressure and cavernosal morphology in normocholesterolemic rats.

OBJECTIVE: A debate is open on the effects of lipid-lowering drugs on sexual function. We aimed to investigate the effect of atorvastatin use on penile intracavernosal pressure (ICP) and cavernosal morphology. MATERIAL AND METHODS: Fourteen mature male Sprague-Dawley-rats were randomly assigned to either the control group (which received standard food and water ad libitum) or the atorvastatin group (which received standard food, water, and statin) for twelwe weeks. At the end of the study, ICPs were measured with cavernosometry. Penectomy specimens were histologically examined. RESULTS: The following mean values were obtained for the control and atorvastatin groups, respectively: pre-study body weights (350±16.9 g and 331.4±24.9 g); post-study body weights (356±18 g and 368±22.5 g (p>0.05); ICPs at 5 V (5.96±5.16 mmHg and 2.11±1.22 mmHg (p=0.07)); ICPs at 10 V (18.28±14.1 mmHg and 5.56±5.58 mmHg) (p=0.09); testosterone (1.23±0.78 and 0.78±0.58 mmol/dL) (p=0.39); blood glucose (151±22 mg/dL and 168.6±16.2 mg/dL) (p=0.12); triglyceride (93.4±19.8 mg/dL and 52.1±18.6 mg/dL) (p=0.01); total cholesterol (50.2±7.2 mg/dL and 47.7±6.6 mg/dL) (p=0.51); and low-density lipoprotein (LDL) cholesterol (10.0±4.4 mg/dL and 3.5±2.1 mg/dL) (p=0.01). The mean collagen thickness was similar (p=0.09); but the mean elastin thickness increased in the atorvastatin group (p=0.01). CONCLUSION: The present study showed that the use of atorvastatin reduced the intracavernosal pressure in 10 V stimulation, and minimally decreased testosterone levels in rats, within a short period of time. When statin treatment is considered for its protective properties on cardiovascular system or for its lipid-lowering effect. It should be kept in mind that atorvastatin may also adversely contribute to erectile dysfunction.

Cutaneous metastasis of colon adenocarcinoma.

Skin metastasis originating from colorectal cancer is a rare entity and usually signifies poor prognosis. We present a case of a 62-year-old male patient who presented with a cutaneous metastatic focus on his forehead after five years of the primary treatment of colon cancer. Complete response from the cutaneous metastasis nodule was achieved with radiotherapy. The patient is still alive and under a second-line palliative chemotherapy regimen because of the multiple liver metastases. It is important for physicians to be aware of skin metastasis in patients with an oncology history.

Pure large cell neuroendocrine carcinoma of the bladder without urological symptoms.

Neuroendocrine carcinoma is one of the uncommonly seen pathologies of the urinary bladder. Macroscopic hematuria is frequently encountered symptom in patients with neuroendocrine carcinoma. We report a 45-year-old man with left solitary kidney and oliguria for five days the development of acute renal failure (ARF) with the impaired general condition. The underlying cause being identified as pure type large-cell neuroendocrine carcinoma of the bladder. Large-cell neuroendocrine carcinoma of the bladder is an uncommon fatal tumor. No macroscopic hematuria or urological symptom was observed in our case. Advanced ectasia was not observed in the kidney, and the patient's clinical status was complicated with ARF. It must not be forgotten that in some bladder tumors, the patient's general condition may be impaired without urological symptoms.

Effect of a Carbohydrate-Rich Diet on Rat Detrusor Smooth Muscle Contractility: An Experimental Study.

OBJECTIVES: We aimed to investigate the effect of a carbohydrate-rich diet on detrusor contractility in rats. MATERIALS AND METHODS: Sprague-Dawley rats were randomized into two groups. The control group received regular food and water. The study group received carbohydrate-rich diet for six weeks. The rats' detrusor muscle was isolated for pharmacological and histopathological examinations. RESULTS: In the control and study groups, mean body weights were 431.5 ± 27.6 g and 528.0 ± 36.2 g, respectively (p < 0.001). Electrical stimulation of the detrusor strips of the control group resulted in gradual contraction. A decreased contractile response was shown in the study group. Acetylcholine in 10-7-10-3 molar concentration produced a decreased contractile response in the study group, compared to the control group (p < 0.01). The study group showed marked subepithelial and intermuscular fibrosis in the bladder. CONCLUSION: Carbohydrate-rich diet causes marked subepithelial and extracellular fibrosis and changes in contractility in the detrusor within a six-week period. Changes have higher costs in therapeutic choices and correction of these changes remains difficult. Putting an end to carbohydrate-rich diet would seem to be more cost-effective than dealing with the effects of consuming it in high proportions which should be the national policy worldwide.

The effect of caffeic acid phenethyl ester (CAPE) on tympanosclerosis.

OBJECTIVE: To investigate the effects of caffeic acid phenethyl ester (CAPE) on tympanosclerosis. MATERIALS AND METHODS: Thirty-two male Sprague Dawley rats were separated into 4 groups as CAPE (n = 10), alcohol (n = 10), control (n = 8) and normal (n = 4) groups. All tympanic membranes except normal group were myringotomised and type 3 Streptococcus pneumoniae strains was injected into their middle ears. Myringotomies were repeated for 5 weeks. Intraperitoneal (i.p) CAPE were administrated to the CAPE group at 10 µmol/kg/day and 10% ethyl alcohol administrated to the alcohol group for 5 weeks. The control group were left untreated. Findings of myringosclerosis were recorded by otomicroscope at sixth week. Then, all rats were sacrificed and tympanic membrane thickness and severity of middle ear mucosal inflammation evaluated histopathalogically. RESULTS: Severity of myringosclerosis was significantly higher in the alcohol and control groups compared to the CAPE group (p < 0.001), but was not significant when alcohol and control groups were compared (p = 0.17). The tympanic membrane thickness measured in the alcohol and control groups were significantly higher compared to the CAPE group (p < 0.001), but was not significant when alcohol and control groups were compared (p = 0.17). The severity of inflammation in the middle ear mucosa was significantly higher in the alcohol and control groups compared to the CAPE group (respectively, p < 0.001, p = 0.03). The severity of inflammation in the middle ear mucosa was not significant between alcohol and control groups (p = 0.30). CONCLUSION: CAPE has anti-inflammatory and antioxidant effects on the development of MS in myringotomized rats, so reduces the severity of tympanosclerosis.

Pathological Investigation of Childhood Foreskin: Are Lichen Sclerosus and Phimosis Common?

OBJECTIVE: To evaluate histopathological results of foreskin removed during circumcision in the pediatric age group and the relationship between these and the degree of phimosis. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey, from June to December 2014. METHODOLOGY: Male children undergoing planned circumcision were examined for the presence and degree of phimosis which was recorded before the operation. After circumcision, the preputial skin was dermatopathologically investigated. Pathological investigation carefully evaluated findings such as acute inflammation, chronic inflammation, increased pigmentation and atrophy in addition to findings of Lichen Sclerosus (LS) in all specimens. The pathological findings obtained were classified by degree of phimosis and evaluated. RESULTS: The average age of the 140 children was 6.58 ±2.35 years. While 61 (43.6%) children did not have phimosis, 79 (56.4%) patients had different degrees of phimosis. Classic LS was not identified in any patient. In a total of 14 (10%) children, early period findings of LS were discovered. The frequency of LS with phimosis was 12.6%, without phimosis was 6.5% (p=0.39). The incidence of histopathologically normal skin in non-phimosis and phimosis groups was 37.7% and 22.7%, respectively. In total, 41 (29.3%) of the 140 cases had totally normal foreskin. CONCLUSION: Important dermatoses such as LS may be observed in foreskin with or without phimosis. The presence of phimosis may be an aggravating factor in the incidence of these dermatoses.

Vascular leiomyoma of an extremity: Report of two cases with MRI and histopathologic correlation.

Vascular leiomyoma is a benign, usually solitary tumor arising from the tunica media of the vein. It can occur anywhere in the body wherever smooth muscle is present. These masses are commonly found in the uterus, urogenital tract and gastrointestinal tract but also less commonly in the extremities. They occur more often in the lower extremities than the upper extremities. Females are more affected than males and are generally seen in the third and fourth decades of life. We present magnetic resonance imaging, and histopathologic features of two pathology proven subcutaneous vascular leiomyomas of the hand and lower leg.